, Hae Il Cheong, Jung Won Lee Idiopathic renal hypouricemia is a hereditary disease characterized by abnormally high renal uric acid clearance. A defect in the
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, Ki Tae Bang, Jong Ho Shin, Ju Ri Kim, Joo Heon Kim, Jin Uk Jeong A 35-year-old man presented with progressive dyspnea and hemoptysis. His blood pressure was 230/140 mmHg and serum creatinine level was 20.13 mg/dL. Chest radiography and computed tomography revealed pulmonary hemorrhage. His renal function was low, thus emergent renal replacement therapy was required. Malignant hypertension and acute kidney injury were diagnosed, and antihypertensive therapy and hemodialysis started immediately. Renal biopsy was performed to examine the underlying disease. Typical pathological changes of malignant hypertension, fibrinoid necrosis of the afferent arterioles, and proliferative endoarteritis at the interlobular arteries were observed. His renal function improved gradually and pulmonary hemorrhage completely disappeared with administration of antihypertensive agents. Here, we report this rare case of malignant hypertension with pulmonary alveolar hemorrhage and speculate that the hemorrhage may be related to vascular injuries at the alveolar capillary level caused by malignant hypertension.
, Sung Jin Kim, Ji Hei Cha, Seung Joo Lee, Sejung Sohn Influenza virus infection is a common respiratory disease in children. Renal complications of influenza infection were not commonly encountered until the 2009 H1N1 influenza pandemic, when acute kidney injury (AKI) frequently developed in severely ill patients. Kawasaki disease (KD) is another rare association in pandemic influenza virus infections. There are some reports about KD coincident with influenza A H1N1/09 infection. However, simultaneous AKI and KD in influenza A or B virus infections have never been reported. Herein, we report the first case of influenza B virus infection that initially presented as AKI but was subsequently diagnosed as atypical KD.
, Duk-Hee Kang Kidney transplantation is the best treatment for end-stage renal disease patients. However, the relative shortage of organs for transplantation has led to ABO-incompatible kidney transplantation as an accepted method to expand the pool of kidney donors. Recent advances in immunosuppression and antibody removal methods have made ABO-incompatible kidney transplantation more feasible, and have increased the opportunities for patients to receive kidney transplantation, as well as for special patients with ABO-compatible donor. Indeed, the outcome of ABO-incompatible kidney transplantation has shown remarkable developments and is now comparable to that of ABO-compatible kidney transplantation during last decade. However, there are still some uncertain issues to be addressed in ABO-incompatible kidney transplantation. In this article, we reviewed the current status and protocol of ABO-incompatible kidney transplantation and listed the concerns to be addressed in near future.
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, Youn Kyung Kee, Eunyoung Lee, Choong-kun Lee, Seung Gyu Han, Su Jin Heo, Tae-Hyun Yoo Malakoplakia is an uncommon chronic granulomatous inflammatory disease which is associated with immunocompromised conditions such as malignancy, autoimmune disease, chronic alcohol intake, poorly controlled diabetes and long-term steroid use. Malakoplakia can occur at various sites, most commonly in the genitourinary tract including urinary bladder and the ureter. Renal parenchymal involvement is relatively uncommon, accounting for 15% of all malakoplakia. A few cases of renal malakoplakia have been reported in Korea, and only one case was accompanied by acute kidney injury. Here we report an 80-year-old female patient with renal parenchymal malakoplakia and acute interstitial nephritis presented as acute kidney injury with literature review.
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, Sun Seob Park, Eun Jeong Ko, Si Won Lee, Mihong Choi, Kiwon Kim Small cell lung cancer is primarily treated with chemotherapy. For patients with end-stage renal disease (ESRD), systemic chemotherapy is often challenging since renal excretion of chemotherapeutic agents might be decreased due to impaired renal function, leading to increased toxicity. No consensus is made so far regarding appropriate dosage and combination of chemotherapeutic agents for patients on hemodialysis. We report two cases of chemotherapy without significant toxicity in small cell lung cancer patients who were on hemodialysis for ESRD.
, Do-Youn Kim, Tae-Oh Kim, Ji-Yun Bae, Shina Lee Spontaneous renal rupture with subcapsular renal hematoma is a rare disease entity. Hereby, we report a 60-year-old female who presented with abrupt right flank pain and was diagnosed as spontaneous renal rupture with subcapsular hematoma related to urinary tract infection and review related literatures.
, Kyung Jin Kim, Sung Chul Hong, Suk Hyung Kang, Ha Eung Song, Hye In Kim, Soo Hyun Kim, Hyun Jung Oh, Hye Won Kang, Seo Woo Kim, Min-A Yu, Dong-Ryeol Ryu, Kyu-Bok Choi, Duk-Hee Kang Blockers of renin-angiotensin system(RAS) including ACE inhibitor or ARB are one of the most frequently prescribed medications for the treatment of hypertension, heart failure and proteinuria. One of the major side effects of these RAS blockers is the deterioration of renal function, mainly due to a reduction of intraglomerular pressure. Therefore, close monitoring of renal function is recommended when RAS blockers are initially prescribed, especially for the patients with impaired renal function.
We report a patient who was transferred to our hospital due to the sudden development of oliguria and dyspnea after treatment for hypertension with ACEi and ARB. She was finally diagnosed as RAS blocker-induced acute renal failure with pulmonary edema complicated on congenital solitary kidney. After hemodialysis and conservative treatment, her renal function was recovered with maintenance of normal urine output.
This case highlights the necessity of the functional and structural evaluation of kidney to prevent the serious complication such as acute renal failure before the administration of ACEi and/or ARB.
, Woo Sik Chung, Bong Suk Shim, Deok Hee Kang Chronic kidney disease(CKD) and Sexual dysfunction are important public health problems in older man as a part of life. We investigated the relationship between two groups.
We examined sixty-five CKD patients on glomerular filtration rate (GFR), serum creatinine (sCr), Prevalence period and causative disease. Sexual function was evaluated by International Index of Erectile Function(IIEF-5), libido(2 items), ejaculation(4 items), frequency of sex in a month and serum testosterone. A control group composed of eighteen male adults who had visited to the general medical testing center in the hospital. They didn't have any combined disease and they were similar age range to the group of the CKD. We analyzed correlations between components of the CKD and sexual function.
The study revealed that all sexual components of the CKD group(mean age 51.8±2.6) were significantly worse than the control group; 12.3±3.9 of IIEF-5, 5.4±1.8 of libido and 10.1±2.2 of ejaculation, 1.4±0.7times of sex in a month in the CKD group and 18.3±3.5 of IIEF-5, 7.2±2.1 of libido and 15.3±2.9 of ejaculation, 2.9±1.1 times of sex in a month in the control group. The patients whose prevalence period of CKD was over than 3 years or whose sCr was over than 2.0ng/ml, had all sexual components worse significantly. Comparing by the causative disease of the CKD, there was no any significant difference. Analyzing by correlation, erectile function is related with serum glucose, sCr, Prevalence periods and libido is related with prevalence periods, and ejaculation is related with diabetes.
The patients with CKD may have a sexual dysfunction that make erection, libido and ejaculation and the number of their sex seemed to decrease. Therefore we need to have more attention to their sexual function as an important part of life.
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, Min Cheol Han, Sung Jae Park, Jun Ho Jung, Bong Suk Shim, Min Sun Cho Ectopic ureteral orifice presents predominantly in young girls with duplicated kidneys and ureters, and mostly drains from ectopic ureters were associated with non-duplicated upper urinary systems and it is called a single system ectopic ureter. It is frequently associated with renal dysplasia or agenesis and ureterocele. Compared with ectopic ureter draining from the duplicated kidney, the diagnosis of single system ectopic ureter is often delayed because the ectopic ureter may be associated with a single small dysplastic, poorly functioning kidney. We report a case of single system ectopic ureter associated with dysplastic and poorly functioning kidney.
, Ku Yong Chung, Jeong Soo Suh, Chung Sik Rhee Our purpose was to discuss the current results of renal transplantation at our institute and to document the usefulness of the ultrasonography in the follow-up of renal allograft.
Thirty five renal allografts who operated and followed-up at our hospital were included. All patients underwent renal duplex and Doppler sonography. According the clinical course of allograft, the sonographic findings were classified into successful renal transplantation(SRT), acute rejection(AR), chronic rejection(CR), and graft failure(GF). We retrogradely analyzed the sonographic findings as follows : renal size(length, width, thickness), cortex echogenicity, corticomedullary differentiation, renal sinus and pyramid, renal pelvis, resistive index(RI).
Results of allografts were as follows : SRT, 24 case(68.6%) ; AR, 6(17.1%) : CR, 3(8.6%) ; and GF, 2(5.7%). The changes of length of allografts were shown no statistically significant changes between the groups, but there is significant increase of thickness of allograft in AC and GF with significance. The mean RI was statistically increased in AR(RI=0.87), and the mean RI's of other groups were 0.65, 0.70, and 0.67 in order to SRT, CR, GF. Parenchymal echogenicities are changed in 66.7% of AC and CR, 25% of SRT, and 50% of GF without clinical significance. There are changes of CMJ, pyramid, sinus echo, renal pelvis of allografts, however, which were shown no statistical significance.
Even though we have small cases and short experiences of renal transplantation at our institute, we considered we have relatively good results and it was guessed there were many efforts for the renal transplantation. The duplex and Doppler sonography were useful tools in the follow-up of allograft, especially deciding acute rejection and graft failure, although it is difficult to decide chronic rejection and can not used to differentiate between the main parenchymal causes of graft failure.
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